Contract Negotiation Manager

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Lead comprehensive contract negotiations, execution, and analysis with ancillary providers, physician groups, and smaller or local systems.

• Oversee contract performance and create as well as implement value-based arrangements that align with organizational strategy.

• Identify, recruit, and onboard providers to achieve network expansion and adequacy goals.

• Provide competitive and sustainable cost arrangements.

• Collaborate across functions on provider compensation strategy, pricing development, and reimbursement modeling.

• Analyze financial and operational data to uncover cost-saving opportunities and execute significant initiatives.

• Represent the organization in interactions with providers, customers, and community stakeholders.

• Contribute to the provider network strategy in accordance with state requirements, product demands, and cost management objectives.

• Enhance provider engagement and address escalations related to claims, contract interpretation, and the accuracy of provider data.

⛳️ Requirements

• Over 5 years of experience in negotiating contracts with ancillary providers, facilities, and physician groups.

• Experience in developing contract language, analyzing rate proposals, and identifying opportunities for operational and financial improvements.

• Capability to utilize competitive market data, financial metrics, and detailed analysis to achieve favorable contract results.

• More than 3 years of experience in provider relationship management or related healthcare positions.

• Demonstrated expertise in contract management.

• Strong understanding of provider reimbursement methodologies, contract structures, and industry-standard payment policies and practices.

• Comprehensive knowledge of provider financial drivers, regulatory requirements, and competitive market dynamics.

• Advanced proficiency in Microsoft Office applications, including Excel, Word, and Outlook.

• Ability to cultivate and maintain collaborative relationships with providers and resolve complex contract issues across functions.

• Excellent prioritization and organizational skills; ability to handle multiple negotiations and competing priorities while adhering to deadlines.

• Candidates must reside in Illinois.

• Willingness to travel up to 10%.

• Bachelor’s degree preferred or a combination of relevant professional experience and education.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program.